What you are describing is a non-standard thing so doing it without using
non-standard macros or a plugin isn't really possible.
There are ways to do the equivalent using tiddlywiki, but instead of having
html input elements you should use edit-text widgets, to make the tiddler
with the given name and the fields use a set-text widget. Reversing the
string would be a non-standard macro, the core doesn't have anything to do
that build-in.
Forms in wikitext are simple, just put this inside a tiddler for all of the
things you described aside from the reversing the text and the custom
javascript part, because they require custom macros which you explicitly
said you didn't want to use:
Tiddler name: <$edit-text tiddler='$:/temp/NewTiddlerThing' field=
'tiddler-name'/>
Text1: <$edit-text tiddler='$:/temp/NewTiddlerThing' field='text1'/>
Text2: <$edit-text tiddler='$:/temp/NewTiddlerThing' field='text2'/>
<$list filter='[field:title{$:/temp/NewTiddlerThing!!tiddler-name}]'>
Warning! The tiddler <<currentTiddler>> already exists!!
</$list>
<$button>
Make it!
<$action-setfield $tiddler={{$:/temp/NewTiddlerThing!!tiddler-name}} text={{
$:/temp/NewTiddlerThing!!text1}} text2={{$:/temp/NewTiddlerThing!!text2}}/>
</$button>
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